Employment Application Form

1. Personal Details
Please complete the bellow fields regarding your personal details
ForenameMiddle Name (s)Surname
Phone Number*
Email*

Confirmation EmailConfirm email
Address*

House Number

Street

TownPost Code

CountyCountry
How did you hear about We Care?*

Word of MouthWebsiteLinkedInFacebookTwitterFlyers/ PostersOther (Please Specify)

2. Professional Details
Please complete the bellow fields regarding your professional qualifications, training and employment history from your 18th birthday
Professional Body Registration*
Registration Number*
Curriculum Vitae (including reason for leaving previous roles)*

Formats accepted are PDF, DOC and DOCX
Cancelof
Professional Indemnity Insurance*

YesNo
Professional Indemnity Insurance Details*
Qualifications and Training

3. References
Please provide details for two referees, one of them needs to be your most recent employer/ line manager
First Reference*
Second Reference*

5. Criminal Disclosure
Please answer the following questions to the best of your knowledge. As per regulations, all applicants are subject to an Enhanced Barred AccessNI check that is carried out during the recruitment process.
Have you ever been convicted of any criminal charges?*

YesNo
Have you ever been given any cautions by the police service or courts?*

YesNo
Have you ever been placed on a Children's Barred List?*

YesNo
Have you ever been placed on a Vulnerable Adults Barred List?*

YesNo
If you have answered yes to any of the questions bellow please provide further details on the field bellow.

6. Health Declaration
Please answer to all question bellow
Do you suffer from any medical conditions that impair or may impair your ability to safely carry out the normal duties of the role applied to?*

YesNo
Have you ever suffered from any medical conditions that impair or may impair your ability to safely carry out the normal duties of the role applied to?*

YesNo
Are you currently the subject of any medical investigations that may impair your ability to safely carry out the normal duties of the role applied to?*

YesNo
Do you suffer from any conditions that required any adjustments to be made to enable you to safely carry out the duties of the role applied to?*

YesNo
If you have answered yes to any of the questions bellow please provide further details on the field bellow.

8. Declaration & Submission
By ticking the box bellow, I hereby confirm that all the information provided above is truthful and accurate*
Should be Empty:

Team Member Application